Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway.
Br J Cancer. 2018 Aug;119(5):646-656. doi: 10.1038/s41416-018-0240-5. Epub 2018 Sep 11.
Excess body weight and weight gain have been reported to independently increase the risk of several cancers. There are few published studies in nationally representative populations of women on specific, 'obesity-related' cancers in relation to prior weight change and relevant confounders.
Based on self-reported anthropometry, we prospectively assessed body mass index (BMI), weight change over 6 years and subsequent obesity-related cancer risk in the Norwegian Women and Cancer study. We used Cox proportional hazard models to calculate hazard ratios and restricted cubic splines to model potential non-linear dose-response relationships.
Excess body weight increased the risk of overall obesity-related cancer, postmenopausal breast, colorectal, colon, endometrial and kidney cancer, with endometrial cancer showing a threefold elevated risk. High weight gain ( ≥ 10 kg) increased the risk of overall obesity-related cancer, postmenopausal breast, endometrial and pancreatic cancer. The association between high weight gain and pancreatic cancer was strong, with 91% increased risk.
Maintaining stable weight in middle adulthood, irrespective of BMI category at baseline, and avoiding excess body weight are both important in the prevention of several obesity-related cancers in women. Our finding of increased risk of pancreatic cancer in women with moderate and high weight gain is novel.
超重和体重增加已被报道可独立增加多种癌症的风险。在针对特定的、与体重变化和相关混杂因素有关的“肥胖相关”癌症的全国代表性女性人群中,发表的研究较少。
基于自我报告的人体测量数据,我们前瞻性地评估了挪威妇女与癌症研究中 6 年内体重指数(BMI)、体重变化与随后肥胖相关癌症风险之间的关系。我们使用 Cox 比例风险模型计算危险比,并使用限制性三次样条来模拟潜在的非线性剂量反应关系。
超重会增加整体肥胖相关癌症、绝经后乳腺癌、结直肠癌、结肠癌、子宫内膜癌和肾癌的风险,子宫内膜癌的风险增加三倍。体重增加过多(≥10kg)会增加整体肥胖相关癌症、绝经后乳腺癌、子宫内膜癌和胰腺癌的风险。体重增加过多与胰腺癌之间的关联很强,风险增加了 91%。
在中年保持稳定的体重,无论基线时的 BMI 类别如何,以及避免超重,这对于预防女性多种肥胖相关癌症都很重要。我们发现体重适度和过度增加的女性患胰腺癌的风险增加,这是一个新发现。